| Quarry Premier Medicine LLC | |
|
2700 Quarry Lake Dr Ste 200 Baltimore MD 21209-3762 | |
| (410) 415-5814 | |
| Not Available |
| Full Name | Quarry Premier Medicine LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2700 Quarry Lake Dr Ste 200, Baltimore, Maryland |
| Authorized Official Name and Position | Erica Joy Dewitt (OWNER) |
| Authorized Official Contact | 4106084612 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Quarry Premier Medicine LLC 2700 Quarry Lake Dr Ste 200 Baltimore MD 21209-3762 | Quarry Premier Medicine LLC 2700 Quarry Lake Dr Ste 200 Baltimore MD 21209-3762 Ph: (410) 415-5814 |
| NPI Number | 1225922362 |
|---|---|
| Provider Enumeration Date | 06/04/2025 |
| Last Update Date | 08/11/2025 |
| Certification Date | 08/11/2025 |
| Medicare PECOS PAC ID | 9133622780 |
|---|---|
| Medicare Enrollment ID | O20250910004555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225922362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| Provider Name | Erica Dewitt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962820688 PECOS PAC ID: 7012210321 Enrollment ID: I20211122000307 |
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